Journal of Clinical Medicine

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Dr. José Ramón Aparicio

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Guest Editor

Endoscopy Unit, Hospital General Universitario de Alicante, Alicante, Spain
Interests: EUS; ERCP; interventional endoscopy; pancreato-biliary endoscopy

Dr. Belén Martínez-Moreno

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Guest Editor

Endoscopy Unit, Hospital General Universitario de Alicante, Alicante, Spain
Interests: EUS; ERCP; interventional endoscopy; pancreato-biliary endoscopy

Special Issue Information

Dear Colleagues,

Advances in biliopancreatic endoscopy have been enormous in recent years. While it seemed that ERCP was losing its diagnostic facet with the advent of echoendoscopy, the emergence of cholangioscopy has recovered and complemented echoendoscopy in the optical diagnosis of intraductal biliary or pancreatic lesions. In addition, cholangioscopy has extended the therapeutic options of ERCP, allowing for access or treatment that was not possible before.

On the other hand, therapeutic endoscopic ultrasound has opened up the possibility of treating biliopancreatic pathology that cannot be treated by ERCP, either by accessing the bile duct, draining it, or creating enteroanastomoses, opening up an infinite number of therapeutic options that were previously inaccessible in many cases. Although this therapy has traditionally been reserved for malignant or palliative pathology, some of these endoscopic interventional procedures may have a place in the treatment of benign pathology in the future. For this Special Issue, we welcome authors to submit papers on clinical advances in biliary and pancreatic endoscopy in terms of both diagnosis and treatment.

Dr. José Ramón Aparicio
Dr. Belén Martínez-Moreno
Guest Editors

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Keywords

EUS-guided biliary drainage
EUS-guided gastrojejunostomy
cholangioscopy
pancreatoscopy
EUS-guided pancre-aticogastrostomy

Published Papers (2 papers)

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Research

9 pages, 473 KiB

Open AccessArticle

Assessment of The Factors Related to The Spontaneous Passage of Common Bile Duct Stones

by Bayram İnan, Ahmet Akbay, İbrahim Ethem Güven and Osman Ersoy

J. Clin. Med. 2024, 13(9), 2672; https://doi.org/10.3390/jcm13092672 - 2 May 2024

Viewed by 375

Abstract

Background: Common bile duct (CBD) stones may pass spontaneously without any intervention. Assessment of the predictors of spontaneous passage can contribute to avoiding unnecessary endoscopic retrograde cholangiopancreatography (ERCP) implementation. This study aimed to investigate the factors related to spontaneous passage of CBD stones. Methods: From January 2021 to August 2023, patients with naïve papilla who had undergone biliary ERCP and with CBD stones detected by MRCP before the procedure were analyzed retrospectively. Subjects were divided into two groups on the basis of the presence of stones during the ERCP procedure: the spontaneous passage group and the non-passage group. Groups were compared in terms of demographic, laboratory, and radiological data. Results: A total of 236 patients, including 26 in the spontaneous passage group and 210 in the non-passage group, were involved. Multivariate logistic regression analyses revealed that only stone size was significantly associated with spontaneous passage. From ROC curve analysis, stone size with a cut-off value of 4.3 mm predicted spontaneous passage with 58% sensitivity and 85% specificity. Conclusions: Stones with a size of less than 4.3 mm are more likely to pass spontaneously without endoscopic intervention. Paying attention to the stone diameter before ERCP procedures can contribute to avoiding unnecessary ERCP implementation. Full article

(This article belongs to the Special Issue Endoscopic Management of Hepato-Pancreato-Biliary Disease)

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14 pages, 1228 KiB

Open AccessArticle

Early and Late Readmissions of Radiation Proctitis in the United States: Are We Getting Better?

by Dushyant Singh Dahiya, Bhanu Siva Mohan Pinnam, Michelle Ishaya, Saurabh Chandan, Manesh Kumar Gangwani, Sahib Singh, Hassam Ali, Amir Humza Sohail, Andrew Canakis, Daryl Ramai, Christina Zelt, Sumant Inamdar, Mohammad Al-Haddad, Mariajose Rojas-DeLeon and Neil R. Sharma

J. Clin. Med. 2024, 13(2), 423; https://doi.org/10.3390/jcm13020423 - 12 Jan 2024

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Abstract

Background/Aims: Radiation proctitis (RP), a well-known complication of pelvic radiation therapy, may lead to recurrent hospitalizations. We aimed to assess readmissions of RP in the United States. Methods: We analyzed the Nationwide Readmission Database from 2016 to 2020 to identify all 30-, 60-, and 90-day readmissions of RP in the United States. Hospitalization characteristics, predictors, clinical outcomes, and healthcare burdens were assessed. Results: From 2016 to 2020, we noted a declining trend of 30-, 60-, and 90-day readmissions of RP in the US. However, the all-cause 30-, 60-, and 90-day readmission rates of RP were still high at 13.7%, 19.4%, and 23.16%, respectively. On readmission, RP was identified as the admitting diagnosis in only 20.61%, 17.87%, and 15.76% of 30-, 60-, and 90-day readmissions, respectively. The mean age for all readmissions was 70 years with a significant male dominance. Lower endoscopy at index admission reduced the risk of readmissions within 90 days, but this was not statistically significant. However, the Charlson Comorbidity Index (CCI) score was an independent predictor of all readmissions. Furthermore, the mean length of stay was 5.57 (95% CI 5.15–6), 5.50 (95% CI 5.12–5.89), and 5.47 (95% CI 5.07–5.87) days and the mean hospitalization charge was USD 60,451 (95% CI USD 54,728–66,174), USD 62,671 (95% CI USD 57,326–68,015), and USD 62,144 (95% CI USD 57,144–67,144) for 30-, 60-, and 90-day readmissions. The all-cause inpatient mortality for 30-, 60-, and 90-day readmissions was 3.58%, 3.89%, and 3.46%, respectively. Conclusions: RP readmissions are a significant healthcare burden. Further efforts must be directed toward improving management strategies to reduce readmission rates. Full article

(This article belongs to the Special Issue Endoscopic Management of Hepato-Pancreato-Biliary Disease)

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